Vasculature of the proximal UE

Question 1

Which artery supplies the upper extremity?

Answer 1

Subclavian artery

Question 2

What is the subclavian artery renamed when it descends over the first rib?

Answer 2

Axillary artery

Question 3

How does the axillary artery descend to the upper extremity?

Answer 3

Descends between the clavicle and first rib

Question 4

What surrounds the axillary artery as it descends through the axilla?

Answer 4

Brachial plexus

Question 5

Are the brachial plexus and the axillary artery deep or superficial to the pec minor?

Answer 5

Deep

Question 6

What is the axillary artery renamed once it descends pas the level of the teres major?

Answer 6

Brachial artery

Question 7

What are the borders of the axillary artery?

Answer 7

Border begins: Distal border of 1st rib
Border ends: Distal border of teres major
(in between these: axillary artery)

Question 8

What area of the axillary artery is considered part 1?

Answer 8

The part of the axillary artery that is proximal to the pec minor

Question 9

What area of the axillary artery is considered part 2?

Answer 9

The part of the axillary artery that is deep to the pec minor

Question 10

What area of the axillary artery is considered part 3?

Answer 10

The part of the axillary artery that is distal to the pec minor

Question 11

Part 1 of the axillary artery has how many branches?

Answer 11

One

Question 12

Part 2 of the axillary artery has how many branches?

Answer 12

Two

Question 13

Part 3 of the axillary artery has how may branches? What are they?

Answer 13

Three:
-2 circumflex arteries (anterior and posterior branches), wrap around proximal humerus
-Subscapular artery: gives off circumflex scapular artery (wraps around/goes to back of scapula) & thoracodorsal artery

Question 14

What arteries make up the scapula anastomosis?

Answer 14

Circumflex artery & thoracodorsal artery, dorsal scapular artery, and superscapular artery

Question 15

Which arteries of the scapula anastomosis are branches from the axillary/subscapular artery?

Answer 15

Circumflex scapular artery (CS) and Thoracodorsal artery (TD)

Question 16

Which artery of the scapula anastomosis is a branch from the subclavian/transverse cervical artery?

Answer 16

Dorsal scapular artery

Question 17

Which artery of the scapula anastomosis is a branch from the thyrocervical trunk?

Answer 17

Suprascapular artery

Question 18

What is the purpose of the scapula anastomosis?

Answer 18

Provides a “plan B” of blood supply to the UE through alternative routes if there is any occlusion/damage to the axillary artery

Question 19

What are the alternative routes to supply the UE with blood (offered by the scapula anastomosis)?

Answer 19

Dorsal scapular artery, Suprascapular artery, Circumflex scapular artery, Thoracodorsal artery

Question 20

What are the borders of the brachial artery?

Answer 20

Border begins: distal to teres major
Border ends: bifurcation of cubital fossa (split into ulnar and radial artery) in elbow
In between these: Brachial artery

Question 21

What are the three branches of the brachial artery?

Answer 21

Deep artery of the arm, Superior and Inferior ulnar collateral nerves (these two branches head to the elbow)

Question 22

What does the deep artery of the arm (branch of brachial artery) descend along with?

Answer 22

Radial nerve (along radial/spiral groove of humerus)

Question 23

What is the deep artery of the arm (branch of brachial artery) renamed when it emerges out of the groove? Where does it terminate?

Answer 23

Radial collateral artery, terminates in elbow

Question 24

Where do the superior and inferior collateral arteries terminate?

Answer 24

The elbow

Question 25

What does the basilic vein drain?

Answer 25

Medial upper extremity

Question 26

What does the basilic vein merge with? Once merged, it drains into which vein?

Answer 26

Merges with brachial vein, drains into axillary vein

Question 27

What does the axillary vein drain into?

Answer 27

Subclavian vein

Question 28

What vein merges with the IJV to form the brachiocephalic vein?

Answer 28

Subclavian vein

Question 29

What does the cephalic vein drain?

Answer 29

Lateral upper extremity

Question 30

Where does the cephalic vein ascend?

Answer 30

Superficial along lateral arm

Question 31

What does the cephalic vein enter?

Answer 31

The clavipectoral (deltopectoral) triangle

Question 32

What does the cephalic vein drain into?

Answer 32

Axillary vein (“dives deep” to get there)

Question 33

When is the axillary vein renamed to the subclavian vein?

Answer 33

When the axillary vein passes under the clavicle and over the first rib (in order to enter the superior aperture of thorax)

Question 34

Once the subclavian vein merges with the IJV and becomes the brachiocephalic vein, where does it drain?

Answer 34

Into the SVC (and back to the heart)

Question 35

What is a clinical application of the subclavian vein?

Answer 35

Subclavian vein central line placement

Question 36

How can you locate the subclavian vein for a central line placement?

Answer 36

By locating the junction of the proximal third and middle third of the clavicle (medial to half way point of the clavicle)

***Subclavian artery also posterior to subclavian vein, use caution